Buying prescription medicine in Spain? (Envarsus XR – transplant)

[iolaire]

Next month I'll be on a trip to Spain.  I'm wondering if it would be possible to purchase Envarsus XR (tacrolimus) in Spain if I found the right pharmacy.  From what I've read in Spain the pharmacists control access to medicine and I could bring over the prescription from here in the US.  I see some press release that Veloxis Pharmaceuticals A/S has the rights to sell the pills there.

My goal here is to build up a few month buffer of my transplant saving Envarsus XR pills.  Here in the US I can only get a 30 day supply of pills at a time so I'm often near the end of my supply with no backup in case of emergency. (I'd pay with cash.)

Does anyone have experience buying medicine in Spain?  Or any suggestions?

[MooseMom]

Oh, I love Spain!  Whereabouts are you going?

I've never bought prescription drugs in any foreign country, so I can't help you there, BUT...

I use my tx center's mail order pharmacy for my immunosuppressants.  They send me a 30 days supply each month.

I use Walgreens' mail order pharmacy for my other prescriptions (statin, bp med).  I get a 90 days supply from them.

So, I had asked my tx team if they would allow me to have a 90 day script for my tx meds.  They said that they would.  However, my insurance company decided to step between me and my care provider and declare that if I wanted to have a 90 supply, I'd have to go through Walgreens instead of my tx mail order pharmacy.

I didn't want to do that because the tx pharmacy and my tx docs are in constant communication, so if there was a change in my drug regimen, my neph and my pharmacy have a direct line to each other and there's no extra faffing about.

I chose to stay with my tx mail order pharmacy and stay with the 30 day supply regimen.  But that was my personal choice.

My point is that perhaps you could do the same, ie, get permission from you tx team AND your insurance to have a script for a 90 day supply through a big chain pharmacy like Walgreens.  Since you are still a relatively new patient, your tx team might hesitate to do this for you, but it's worth a go.

Did any of that make sense?

OR, you could ask your insurance company to fund some extra months of your meds on this one off basis.  My tx mail order pharmacy suggested this when I was asking the same question because I wanted to go abroad for more than a month.

Let us know what you end up doing.  There must be alternatives because surely tx patients venture outside of the US for more than one month at a time!

[iolaire]

We are going on a package bus trip from Madrid down into Andalusia and then east to Barcelona.  Between two families (youngest is 15) we have 10 people going on package that probably has 40 people on the bus.  It should be good and make travel easier.

I've talked to my doctor and my local pharmacy but at this point Medicare will not pay for more than 30 days everyone says.  I've held onto Medicare despite it being costly and being under a private plan just incase.  I've decided to just let it ride until next July when it will end naturally.  I also feel that being on Medicare made things easier as everyone knows what they will pay and makes decisions based on that.

Back when I was on Aetna RX specialty pharmacy they did send 90 day supplies for very expensive medicines so that might be possible later, but then they also want you to talk regularly with their phone nurses and that's was a hassle - hopefully with transplant patients that will be less of a problem.

[MooseMom]

I hope you have a wonderful time.  Since you will be o a package trip, I'm sure you'll get to hit all of the highlights of the Moorish architecture in Andalusia.  The political climate in Barcelona, with the imprint of Catalonian separatism, is very interesting (if you are interested in that sort of thing).

I've never been on Medicare, so I had not taken that into consideration.  Do you think it would be worth talking to Medicare directly?  While I'm sure your doctor and pharmacist know what they are talking about, who knows if the Medicare rules have changed in this regard!

What you've posted about having to talk with Aetna RX's phone nurses is interesting.  I've been with my tx center's specialty mail order pharmacy for 7 years now, and it has only been in the last two years or so that I've been asked to talk to their pharmacist on a regular (quarterly) basis.  They just ask me if I've noticed any side effects that concern me and if I've missed any doses.  That's about it, so maybe when the time comes, you, being a tx patient, too, will find it to be less of a hassle.

When are you off on your trip?  And, what made you choose Spain for a holiday?

[iolaire]

Susan's mother has wanted to go to Andalusia to "hear the Gypsies sing" since the 1960's or 1970's so we promised to bring her quite a few years ago but she is generally not up to it so when we saw the package we decided that would be a good way to do it as she would not have to keep up with us and could see a lot as part of the bus itinerary.   

I booked a flamenco show at the https://www.casadelamemoria.es/ because I don't think she would enjoy the dinner + drinks and show type flamenco show.  This is only a flamenco show and looks to be very intimate setting.  And she is probably not up to going to the bar's where people sing later in the night.

We head out the day before Thanksgiving, so our tour's welcome dinner will equal Thanksgiving dinner - hopefully its still a Spanish meal!

Regarding Medicare I google around before and I think I found similar complaints of people not being able to get more than a 30 day supply.  Also I'm moving to my wife's federal insurance plan this open season so I was looking at the Aetna and Blue Cross plans - the cost of Envarsus will be huge on those plans when I move off Medicare in July, about $300+ a month so I'm happy I've let Medicare pick up the tab even though my monthly Medicare payments are now over $400 due to my strong income.

[MooseMom]

Gosh, how we Americans pay for medical stuff is just so complicated.  My husband is a few years younger than I am, so I will be eligible for Medicare sooner than he will.  We get our insurance through his employer; it's a BCBS-IL HMO, and I pay only $25 a month for my tx meds.  I sort of dread going onto Medicare because I just don't know what will happen then!  I'm sure they do restrict supply of these drugs as they're not out there to make life easier for us.    I hope you can work it out, and if you do, let me know how you did it!


I hope you enjoy the flamenco show and that it will be a culturally "authentic" experience and not a mere touristy one.  Looking at their website, it looks like it will be great, and Seville certainly worth visiting.  I can't wait to hear more about it once you've returned home!

[kristina]

Next month I'll be on a trip to Spain.  I'm wondering if it would be possible to purchase Envarsus XR (tacrolimus) in Spain if I found the right pharmacy.  From what I've read in Spain the pharmacists control access to medicine and I could bring over the prescription from here in the US.  I see some press release that Veloxis Pharmaceuticals A/S has the rights to sell the pills there.

My goal here is to build up a few month buffer of my transplant saving Envarsus XR pills.  Here in the US I can only get a 30 day supply of pills at a time so I'm often near the end of my supply with no backup in case of emergency. (I'd pay with cash.)

Does anyone have experience buying medicine in Spain?  Or any suggestions?

... How about to ask the US Embassy in Spain and explain your situation? I am sure they can assist you because you certainly need to make sure that the "Continental Version" of your medication does not differ in any way as you cannot afford to upset your new kidney?
Their address is : Calle de Serrano, 75, 28006 Madrid
Good luck and best wishes from Kristina.

[Simon Dog]

The trick is to find an MD who understands the fine art of overprescribing, writing the Rx for a greater quantity than you take "just in case the MD needs to increase the dose".

[Cupcake]

Ditto Simon Dog. That's what I'm doing accidentally. Some months back I was switched from 4 Envarsus/day to three; I kept telling the transplant nurse to change it in my chart/prescription but she  kept the record at 4/day. So I have been stockpiling an extra 30 envarsus every month. Will have to rotate the old stock into the new so it doesn't expire. I am on medicare with my gap plan thru AARP United and they will only give me 30 days of Envarsus at a time. Costs me $137/month for the 120 Envarsus tabs. I guess that's not too bad.

[iolaire]

Ya I'm not to hot on asking them to modify the dose for the prescription as everything is computerized and linked together.  If they "thought" I was on a different level of meds then that would no link up well with the Tacrolimus levels shown in the lab work in the charts etc.…

That being said they probably would be willing to write a paper prescription and I could go fill it with cash, its costly but under $500 for 90 pills so as an insurance policy it might work.
https://www.goodrx.com/envarsus-xr

I do have something like 40 1 mg pills extra as I took two .75 and one 1 mg for a while one month instead of the opposite two 1 mg and on .75 mg.

[Paul]

As a variant on what Kristina said, try the Spanish embassy in the US. I'm sure they will know, and a simple 'phone call to them will do.